AI Article Synopsis
- Urinary sodium (Na) excretion is linked to an increased risk of cardiovascular disease (CVD), but the biological reasons and impact of salt sensitivity are not fully understood.
- This study involved 2112 participants and utilized urine and blood samples to assess the relationship between urinary Na excretion, salt sensitivity (defined by factors like hypertension and metabolic syndrome), and CVD risk over an average follow-up period of 14.1 years.
- The findings revealed that those with high urinary Na excretion (>4.2 g/24 h) faced a 43% higher risk of CVD, primarily mediated by factors such as carotid intima-media thickness and systolic blood pressure.
Article Abstract
Urinary Na excretion is a potential risk factor for CVD. However, the underlying biological mechanisms and effects of salt sensitivity are unclear. The purpose of this study was to characterise the relative contribution of biological factors to the Na-CVD association. A total of 2112 participants were enrolled in this study. Structured questionnaires and blood and urine samples were obtained. Twenty-four-hour Na excretion was estimated using a single overnight urine sample. Hypertension, the metabolic syndrome and overweight status were considered to indicate salt sensitivity. Cox proportional hazard models were used to investigate the effects of salt sensitivity on urinary Na excretion and CVD risk. The traditional mediation approach was used to calculate the proportion of mediation. The mean age (sd) of the 2112 participants was 54·5 (sd 12·2) years, and they were followed up for a mean of 14·1 (sd 8·1) years. Compared with those in the lowest quartile, the highest baseline urinary Na excretion (>4·2 g/24 h) was associated with a 43 % higher CVD risk (hazard ratio, 1·43; 95 % CI 1·02, 1·99). Participants with high urinary Na excretion, hypertension or the metabolic syndrome had a significantly high risk of CVD. The carotid intima-media thickness had the largest mediating effect (accounting for 35 % of the Na-CVD association), followed by systolic blood pressure (BP) (33 %), left ventricular mass (28 %) and diastolic BP (14 %). Higher urinary Na excretion increased the risk of CVD, which was explained largely by carotid media-thickness and systolic BP.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924491 | PMC |
| http://dx.doi.org/10.1017/S0007114521001768 | DOI Listing |
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